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Step-by-Step Guide to Billing for Extended Intervention

Step 1:  Setup and Authorize Patient Insurance 

During patient intake and insurance setup, authorize codes and hours for the child based on diagnosis and coverage for extended intervention, parent training, remote monitoring, etc. 

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Step 2:  Create Content 
In the therapy provider's normal workflow with parents in a therapy session, short training videos and notes are created for the home note. At the end of the session, all parents/caregivers associated with the child receive the session update and home program video clip instructions. 

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Step 3: Engage and Track 
In the days or weeks between a session, caregivers practice the home program and provide video posts and questions back to their therapy team. When the therapy providers engage and provide back answers and additional content, this time is logged in reporting for billable time (with additional audit reporting available). 

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Insurance Billing Point 1: Remote and Asynchronous telehealth (see breakdown between Behavioral, Speech, Physical, and Occupational Therapy below) 

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Step 3: Monitor
Every five days between sessions, caregivers are prompted to complete a remote monitoring questionnaire about the child that is sent to the therapy team. After the therapy team reviews, this is logged in reporting for billable time. 

 

Insurance Billing Point 2: Remote Monitoring (see the breakdown between Behavioral and Medical monitoring below) 

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Step 4: Repeat

Parents return to the clinic or schedule another home visit to repeat the process. Everyone wins! 

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CPT Guidance

Bill Point 1: Asynchronous Time Spent Working with Parents Questions/Videos
Recommendation: Use the extension of the CPT codes for the type of therapy being provided or parent consultation.  
- Behavioral Health (ABA/BCBA): Assessment (97151, 90887); Treatment (97153- 97158); Parent Training (90887)
- Speech and Feeding: Evaluation for a speech-generating device (92607); Evaluation of auditory rehabilitation status (92626), Assessment of aphasia (96105), Standardized cognitive performance testing (96125); Cognitive skills development (G0515) 
Sensory integration (97533)
- PT/OT: Therapeutic (one-on-one) procedures (CPT 97110–97546); Re-evaluations (97164, 97168)l Constant attendance (one-on-one) modalities (97032–97039); Therapeutic (one-on-one) procedures (97110–97546); Tests and measurements (97750–97755); Orthotic and prosthetic management (97760–97762)

Bill Point 2: Remote Monitoring 
Recommendation: Use the appropriate code mapped to the mental or medical health model. 
- Behavioral Health (ABA/BCBA): Care management services for behavioral health conditions (99484; $40-60 a patient a month) 
- Medical (PT, OT, SLP): Remote monitoring (99457; $50 a patient a month) 

Bill Point 1 Sources: 
- ABA 
- Speech and Feeding 
- OT
- PT (Technical and Simplified) 
 

Bill Point 2 Sources: 
- Care Management 
- Medical Remote Monitoring 

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